CARUNCLES AT THE EXTERNAL URETHRAL MEATUS

A 54-year-old man presented with a 3-month history of polyps at the external urethral meatus as well as obstructive voiding symptoms with a splayed urinary stream. The patient had no history of hematuria, trauma, urinary tract infections or sexually transmitted disease. On external genital examination 2 reddish friable polyps were detected at the 2 o’clock and 7 o’clock positions at the external urethral meatus, which were similar in shape to female urethral caruncles (fig. 1, A). Physical examination was otherwise normal. Laboratory findings and urinalysis were normal. The polyps were excised and bases were fulgurated with the patient under a caudal block. After resection, another polyp was detected in the fossa navicularis, which was also resected followed by fulguration (fig. 1, B). Fiberscopic examination to determine whether another lesion was present demonstrated that the urethra and bladder had a normal appearance. The patient was discharged home 3 days postoperatively and convalescence was uneventful. Histopathologically, the polyps consisted of a submucosal fibrin mass with red blood cells. Many capillaries proliferated into the mass from the surrounding stroma, forming capillary lumina of variable sizes and shapes. Mild inflammatory cell infiltration was detected around the capillaries. The surface of the polyps was covered by squamous epithelium (fig. 2). All 3 polyps had the same histopathological findings.